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Rearfoot Striking is Preferred Method of Footstrike for Ultramarathoners

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kevin Kirby, Nov 11, 2012.

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    Marty Hoffmann, MD, and coworkers just posted the results of their video analysis of footstrike patterns of ultramarathoners in the Western States 100 Mile Endurance Run here in California.


    They found that the preferred method of footstrike was rearfoot striking (80-90%) for all four points in the race that they filmed the runners.

    It was also interesting that they also found that serum creatine kinase was lower in the rearfoot strikers than in the midfoot and forefoot strikers. From this preliminary data, it seems reasonable to conclude that possibly the rearfoot strikers did less damage to their muscle during the race than did the midfoot and forefoot strikers.

    Here is what Pete Larson, PhD, from RunBlogger (and author of Tread Lightly) said about this study:

  2. mr2pod

    mr2pod Active Member

    Thanks Kevin for posting this, I was just reading it myself... Looking forward to the full results
  3. JB1973

    JB1973 Active Member

    yep. Read this a couple of weeks ago. Not hugely surprising really.
  4. Actually, I know Marty Hoffman fairly well. He is a pretty good distance runner himself (we are about the same age) and is a physical medicine and rehabilitation specialist at UC Davis Medical Center here in Sacramento. He does a lot of work with the Western States 100 Mile Endurance Run and all my ultra distance running patients seem to know him. He's a great guy and very dedicated to the ultra running community (which is very big) here in the Sacramento/Northern California area.
  5. Marty Hoffman was also involved in a nice debate on barefoot running in a Physical Medicine and Rehab Journal (Krabak BJ, Hoffman MD, Millet GY, Chimes GP: Barefoot running. PM&R 3(12):531–535, 2011).
  6. mdhoffmanmd

    mdhoffmanmd Welcome New Poster

    Thanks for the kind words Kevin.

    Foot strike pattern seems to be a topic of real interest and controversy, and I’m happy to contribute to advancing our knowledge on this topic. As far as I know, this is the first work to examine foot strike pattern in an ultramarathon. Other work has examined marathon and shorter distances. We had hypothesized that ultramarathon runners might tend to use a forefoot/midfoot strike pattern to a greater degree than shorter distance runners in order to control the cumulative effects of impact forces. But, it appears that that is not really the case, and that the natural balance may be more towards an attempt to limit muscle injury from eccentric loading by tending to rely mostly on a heel strike pattern.

    The information posted above was from our email that went to runners participating in the 2012 Western States Endurance Run. It is always our intent to get our research findings back to our study subjects as soon as possible. We try to balance that with avoiding so much media attention that a scientific journal may not be interested in the work because it is no longer new information. Usually, that’s not been an issue.

    With that in mind, I don’t want to provide a lot more details about the work at this point. The work will be presented at the American College of Sports Medicine meeting next May/June. And, the paper is currently in review. Assuming it withstands the peer review process, I would hope it may also be available by the middle of next year. I will be more than happy to discuss publicly at that point. Anyone interested in specific details can contact me directly at martin.hoffman@va.gov.


    Martin D. Hoffman, MD, FACSM, FAWM
    Chief of PM&R, VA Northern California Health Care System
    Professor of PM&R, University of California Davis
    10535 Hospital Way (117)
    Mather, CA 95655-1200
    Phone: (916) 843-9027
  7. Marty:

    Thanks for contributing to this thread and I am anxious, as I'm sure many others are on Podiatry Arena, to see your full experimental results in print once your paper is published.

    Your research adds to the three previously published research studies that clearly shows that rearfoot striking is the preferred method of foot strike for not only recreational but also elite athletes in long distance running events, with 74.9 - 88.9% of all runners being rearfoot strikers.

    753 runners: 81% RF, 19% MF & 0% FF strikers
    (Kerr BA, Beauchamp L et al: Footstrike patterns in distance running. In Nigg BM (Ed.), Biomechanical Aspects of Sport Shoes and Playing Surfaces, University Press, Calgary, 1983, pp. 135-142.)

    283 elite runners: 74.9% RF, 23.7% MF and 1.4% FF
    (Hasegawa H, Yamauchi T, Kraemer WJ: Foot strike patterns of runners at the 15-km point during an elite-level half marathon. J Strength Cond Res, 21:888-893, 2007.)

    936 runners in ½-full marathon: 88.9% RF, 3.4% MF, 1.8% FF strikers
    (Larson P, Higgins E et al: Foot strike patterns of recreational and sub-elite runners in a long-distance road race. J Sports Sciences, 29:1665-1673, 2011.)

    However, since we know that as individuals run faster they tend to footstrike more toward their forefoot and as the same individuals run slower they tend to footstrike more toward their heels, seeing ultramarathoners, who are running slower in general than all other foot races, run with predominantly rearfoot striking pattterns is no great surprise to me. In fact, I would expect that in addition to the slower running speeds, the fatigue of the ultramarathon event would make runners run slower and try to conserve metabolic energy even more than in shorter running events, therefore promoting an increased tendency toward rearfoot striking running.

    Therefore, I don't believe that ultramarathoners are predominantly heel-striking because they are attempting to "limit muscle injury from eccentric loading". Rather, I believe that ultramarathoners are predominantly heel-striking because they are attempting to run in the most metabolically efficient kinematic pattern for the velocity they are running at.

    Joe Hamill, PhD, presented some interesting forward dynamics research on this notion that heel-striking is more metabolically efficient at a recent podiatric biomechanics conference in Manchester, UK, that Simon Bartold and I also lectured at. Hamill and coworkers found that most energy efficient running form at 4.0 m/sec (6:42 min/mile) pace was heel-striking (15.9 W/kg) compared to midfoot striking (16.9 W/kg), a 6.3% difference in efficiency.
    (Miller RH, Russell EM, Gruber AH, Hamill J. Foot-strike pattern selection to minimize muscle energy expenditure during running: a computer simulation study. Proc ASB. State College, PA, 2009.)

    Certainly, being able to extend the running stride length and allow the heel to strike at slower running speed makes sense because it likely increases the metabolic efficiency of running. Since runing velocity is determined by the stride length multiplied times the stride rate, adding a few silly centimeters per stride and allowing your foot to heel strike may signficantly increase running efficiency. Compare this possibly more metabolically efficient way of heel-striking running to the method often advocated by the Pose Running Coach, or the Chi Running Coach, or the Minimalist-Barefoot Zealot friend, where they advocate chopping your stride so you can land on your midfoot or forefoot because this is the "natural and best way to run".

    Therefore, I beleive that optimizing the metabolic efficiency of running in longer distances races is the primary driving factor in determining the kinematics of most runners. And, as the racing distance gets shorter and faster, I believe that maximizing power output becomes increasingly more important than metabolic efficiency, due to the increased anaerobic demands of the shorter distance races.

    Just my two cents on this interesting topic.
  8. mdhoffmanmd

    mdhoffmanmd Welcome New Poster


    It may be that optimizing economy is the determinant of gait under many conditions, but it should be remembered that economy is not always the determinant of movement pattern. For instance, elite cyclists choose a higher rpm than that which is most efficient in order to reduce pedal force and apparently limit muscular fatigue. Cross-country skiers will generally choose a skating technique over the more economical double poling technique probably because the work can be distributed over a larger muscle mass with skating. And if we consider stride frequency in running as an example, while an increased stride frequency over that which is freely chosen is less economical, if it results in reduced loading rates and peak forces, it seems conceivable that a runner might adopt such movement under some circumstances. This refers to the balance of saving the legs vs. saving energy. We’ve discussed this in an editorial we recently wrote (Millet GY, Hoffman MD, Morin JB. Sacrificing economy to improve running performance – a reality in the ultramarathon? J Appl Physiology 2012;113(3):513) which I will be happy to send to anyone.

  9. Marty:

    I would agree that the central nervous system (CNS) probably uses multiple optimization pathways in order to determine the kinematics and kinetics of each individual during athletic activities. Certainly, for running, it would seem that one of the main determinants of it's kinematics and kinetics is that the CNS will monitor afferent input and then adjust efferent output to optimize metabolic efficiency. However, I also agree with you that the CNS likely also attempts to optimize minimization of fatigue, discomfort and pain during running, while, simultaneously, focusing on optimizing metabolic efficiency.

    These factors are the primary reason why I think it is wrong to try to coach an experienced runner to drastically change their footstrike pattern and kinematics by trying to have them achieve some sort new gait pattern that someone has predetermined to be "the ideal running gait". I believe this common practice with the Chi, Pose and other running gait coaching philosophies does not take into consideration that the CNS of each individual is vastly more adept at determining the best running gait pattern for each individual runner than any coach or scientist currently is. However, for the inexperienced runner, I believe that some coaching is generally desired in order to help the runner better understand the running gait process and instruct them on the various techniques that many runners use in order for them to be able to find the technique that is most comfortable and efficient for them.

    Great discussion.:drinks
  10. bruk

    bruk Member

    There are a few things about the Footstrike Debate that continue to baffle me:
    It is an "Either-Or" debate". Why is it that no one talks about the fact that any given runner can use a variety of gait strategies? It is well researched that virtually all of the characteristics of gait change depending on terrain, speed, fatigue, impact, goals, ability, etc. Could it be possible that a runner should be adept at heelstriking AND forefoot striking (and everything in between) to be able to adapt as readily as possible to changes in demand? The debate over watching natural barefoot runners' strike patterns is always interesting, because they exhibit this range of adaptability; when they are running in a high-impact situation their GRFV is anterior to the malleolus, and when it is a low-impact situation the GRFV moves posteriorly to the malleolus.

    This is an interesting study and I look forward to viewing the entire article. However, I would caution against using the term 'Preferred' method of Footstriking for Ultramarathoners. It would be more correct to say 'Self-selected', or 'demonstrated'. 'Preferred' sounds like that's they way they SHOULD run. Maybe it is, maybe it isn't. I'm interested to see what conditions were surrounding the points during the event where runners were observed.

    My practice deals almost exclusively with runners, including quite a few ultrarunners, and I would say anecdotally that they are more apt to employ a midfoot-strike strategy than other runners. They are also more apt to go in the opposite direction in footwear strategy (minimalist) and use high-cushioned shoes like Hokkas, and in fact often do both: midfoot strike in a thick-soled shoe.

    There is clearly objective and subjective evidence of the benefits of barefooting, minimalist shoes, maximalist shoes, heelstriking, midfootstriking, walking on your hands, etc. What if we decided to embrace the positive things and collaborate about how to take advantage of them through changes in movement and footwear strategies, rather than engage in derisive argument? We could probably do some real good for our running population.

    Here are some crazy things I do;
    1. I teach heelstrikers how to be midfoot strikers, and midfoot strikers how to be heel strikers.

    2. I change people's gait through coaching and drills to teach them how to be as adaptable as possible to the myriad of variations in their internal and external running environment.

    3. I sometimes make orthotic devices for runner's in minimalist shoes, and sometimes take orthoses out of stability shoes.

    I love the ridicule I get from doing these things, because when a runner experiences success from out-of-the-box, open minded thinking and innovative strategies, they become critical thinkers that are less likely to blindly "choose a side". Is there a reason we can't be a little less dogmatic about how we approach issues like these?

    By the way, I love this forum. Very educational. But I have to say that there is often a level of underlying sarcasm that creates the implication that opposing thoughts and ideas are of lesser value. It's unfortunate because I think it decreases a greater diversity of responses that would be even more educational.
    I have taken the "Lurk and Learn" approach to this forum for that reason.
  11. Bruk

    The only issue with a change in running gait is if the change is stress causes a tissue to function out of it physiological window.

    As we have no idea until after it happens, ie injury it is hard to say what is correct for 1 person or not or even if changes in running gait will be good or bad.
  12. Bruk:

    Good posting :good: and welcome to Podiatry Arena.:welcome:

    Where do you practice and are you a podiatrist? Many here would be more willing to engage in discussion with you if we knew your name.
  13. CraigT

    CraigT Well-Known Member

    My understanding is that preferred does mean self selected- not that it is anyone else's preference...

    If you are making these changes for specific reasons related to the individual, then this is not really crazy. It is certainly less crazy than doing the same thing for everyone... such as saying they should all be in minimal shoes or all should run a certain way!
    There is some good evidence coming out that suggests gait retraining may be very effective for anterior compartment syndrome...
  14. re - gait retraining I do wonder how you decide or when you decide feature x of the persons running gait needs to be changed.

    Anyone who does a running Gait analysis on a treadmill is missing the boat imo, due to the change in strike pattern which occurs when using a treadmill.

    and when is the persons running Gait reviewed, when they are fresh say 1/3 of a 10 km run, middle 1/3 when in a rhythm or last 1/3 when tired ?

    or all 3 sections and a total review done ?

    or ....... ?
  15. Blaise Dubois

    Blaise Dubois Active Member

    Hi Dr Hoffman and the crew of PA
    I collaborate recently to a study with Guillaume Millet and is group in St-Etienne-France and start to collaborate with his brother Grégoire from Lausanne Switzerland. Both are ultra trailers and run at the best level (Guillaume finish 3rd and Grégoire second at the Tor des Géant -330k-) We have great discussion on technique, minimalism vs maximalism and injuries on ultra trail.
    According to them (and 2012-Lopes), one of the most frequent injury for ultra trailer is the ankle dorsiflexors tendiopathy. A pathology that is exacerbating by heel striking. Like you said economy is just one of the factors that influence biomechanics. I think also that sometime, some factors predominate over other, even if it's not always the best way to survive on the activity (ex: be more economical in the same time to be more detrimental for tissue). What's intriguing me is knowing that heel strike is an "artificial" way to run cause by the protective device we have create, the shoes... and (by observation) more the shoe have a higher heel and more the shoe is protective, more the heel strike increase (foot-ground angle, passive peak, ...).

  16. In my 27+ years of treating ultra-distance runners, including many of those who compete at our local ultra-distance races, the Western States 100 Mile Endurance Run and the American River 50 Mile Run, I have never seen a single one of these ultra-distance runners with "ankle dorsiflexor tendinopathy". To somehow suggest that the 80-90% of ultra-distance runners who prefer to heel strike have an increased rate of "ankle dorsiflexor tendinopathy" is ludicrous.

    What I do see a lot of in ultra-distance runners is Achilles tendinopathy and metatarsal stress fractures, both injuries very common to those runners for convert to forefoot striking-midfoot striking away from their preferred heel-striking running pattern. To somehow suggest that any injury is due to heel-striking when 80-90% of the runners are heel-striking in a running event is about as intelligent as saying that "ankle dorsiflexor tendinopathy" is caused by the wearing of socks, since 80-90% of runners wear socks. Ridiculous!!

    I'm sure that the "minimalist running shoe only-heel striking is bad-orthotics are bad-plantar fasciitis is caused by weak foot muscles zealot camp" led by Blaise Dubois, Mark Cucuzzella and Nick Campitelli would be delighted with the preaching of their agenda to have everyone believe that heel-striking causes "ankle dorsiflexor tendinopathy" and that this is a significant problem in distance runners. However, this is just another anecdotal fallacy being promoted by the "minimalist running shoe only-heel striking is bad-orthotics are bad-plantar fasciitis is caused by weak foot muscles zealot camp" in their vain attempt to keep their biased, non-scientific message from dying the slow death that it will experience within the coming years.:butcher::boxing:
  17. Blaise Dubois

    Blaise Dubois Active Member

    I don't see a lot of ultra-marathoners in my canadian practice, but I speak a lot about that when I'm teaching in Europe. I was just reporting what's the two most important scientists in the world in the field of ultra Trail running are saying... in agreement with the recent systematic review of Lopes... but I know : if kevin say 'no' it's no... it's no for everybody, everywhere, and for ever

    Also, is there good evidence to recommend a maximalist shoe in ultra trailer? How big (stack, drop, stiffness, weight) they need to do? Please enlighten me... I'm a little lost on what to prescribe to my runners.

    Thanks for your help.
    Your devoted blaise
  18. Craig Payne

    Craig Payne Moderator

    There is about as much evidence for maximalist running shoes in ultramarathoners as there is for minimalist running shoes!

    ...So its all going to come down to personal preferences and feel.

    I do recall seeing a comment recently that about a third of runners in a 100km event in the USA were wearing Hoka One One's. That is what I am seeing. Ultramarthoners love the maximalist Hoka's.
  19. Blaise Dubois

    Blaise Dubois Active Member

    I'd say the opposite in Europe. More and more people in more minimal shoes like the 'sense of Salomon' (kilian's shoes)... A lot more than the Hoka. At the UTMB this year, a symposium about minimalist shoes and the 'run to born' book... juste translate in french. Which trend is a fad? Which one will soon become the reference? Future will tell us.
  20. Phil3600

    Phil3600 Active Member

    It would be interesting to see what foot strike patterns were like prior to traditional shoes coming onto the market. Did everyone FF strike then? Is heel striking a new concept?

    I'm not sure about mainland Europe but here in the UK traditional shoes are by far the more common shoe choice. I'm in 2 running clubs and being a pod I get to see a good portion of the running population (maybe there is a study there). And we're damn good at sports...In fact we came third in the Olympics...

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